Cutaneous metastasis of hepatocellular carcinoma diagnosed by fine needle aspiration cytology and Hep Par 1 immunopositivity

Nurismah Md Isa, Jan Jin Bong, Fauzah Abd Ghani, Isa Mohamed Rose, Salina Husain, Muhammad Azrif

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Cutaneous metastasis of hepatocellular carcinoma (HCC) is very rare, accounting for less than 0.8% of all known cutaneous metastases and occurring in 2.7-3.4% of HCCs. With less than 50 such cases reported worldwide, most of which were diagnosed histologically on excised lesions, it can only be expected that diagnosis made on cytological features alone would be challenging. We report a case of cutaneous metastasis of HCC diagnosed based on cytological features and confirmed by Hep Par 1 immunopositivity of the cell block material. An 81-year-old man, who was known to have unresectable HCC, presented with a 1-month history of painless, left nasal alae mass. The mass measured 1.5 cm in diameter, and was multilobulated with a central necrosis. Fine needle aspiration of the mass was done. Smears were cellular, comprising of malignant cells in loose clusters and aggregates as well as singly dispersed. The malignant cells displayed moderate nuclear pleomorphism, occasional prominent nucleoli, and intranuclear pseudoinclusion. Cell block material demonstrated the trabeculae pattern of the malignant cells and Hep Par 1 immunopositivity. The final diagnosis of a metastatic cutaneous HCC was made. In conclusion, cutaneous HCC metastasis is rare and should be considered in the differential diagnosis in patients with a history of HCC presenting with suspicious skin lesion. In the right clinical setting, a confident diagnosis can be made in such cases by using the fine needle aspiration technique aided with immunopositivity for Hep Par 1 antibody of the aspirated material.

Original languageEnglish
Pages (from-to)1010-1014
Number of pages5
JournalDiagnostic Cytopathology
Volume40
Issue number11
DOIs
Publication statusPublished - Nov 2012

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Fine Needle Biopsy
Cell Biology
Hepatocellular Carcinoma
Neoplasm Metastasis
Skin
Nose
Differential Diagnosis
Necrosis
Antibodies

Keywords

  • cell block
  • cutaneous metastasis
  • fine needle aspiration cytology
  • Hep Par 1
  • hepatocellular carcinoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Cutaneous metastasis of hepatocellular carcinoma diagnosed by fine needle aspiration cytology and Hep Par 1 immunopositivity. / Md Isa, Nurismah; Bong, Jan Jin; Ghani, Fauzah Abd; Rose, Isa Mohamed; Husain, Salina; Azrif, Muhammad.

In: Diagnostic Cytopathology, Vol. 40, No. 11, 11.2012, p. 1010-1014.

Research output: Contribution to journalArticle

Md Isa, Nurismah ; Bong, Jan Jin ; Ghani, Fauzah Abd ; Rose, Isa Mohamed ; Husain, Salina ; Azrif, Muhammad. / Cutaneous metastasis of hepatocellular carcinoma diagnosed by fine needle aspiration cytology and Hep Par 1 immunopositivity. In: Diagnostic Cytopathology. 2012 ; Vol. 40, No. 11. pp. 1010-1014.
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